Three-dimensional ultrasonography for planning percutaneous drainage of complex abdominal fluid collections

To identify information provided by three-dimensional (3D) ultrasonography (US) useful for percutaneous drainage of complex abdominal fluid collections.

3D US evaluation of the collection structure and spatial relationship of items of interest was performed immediately before percutaneous access of 46 complex fluid collections in 26 patients (28 procedures). Procedurally useful information was tabulated and analyzed.

In five of 28 procedures (18%), 3D US could not visualize the fluid collections. In 21 of 23 procedures (91%) with adequate US visualization, 3D US provided unique helpful information: in 20 of 21 (95%), the direction of access was selected to favor subsequent manipulation; in 17 of 21 (81%), a single access site could be used for multiple drains; in 17 of 21 (81%), the location of the drain was determined; in 11 of 21 (52%), the number of drains was altered; and in six of 21 (29%), high-risk deep collections were accessed via connections from safer superficial collections. 3D US provided no additional information in two of 23 procedures (9%) and provided misinformation regarding interconnections between collections in two of 23 (9%). Percutaneous drainage was curative in 20 of 26 patients (77%).

In sonographically suitable situations, 3D US can add substantial information on structure and spatial relationships to optimize initial drainage of complex fluid collections.